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The Real Truth about Sugar Kathleen M. Zelman, MPH, RD Recently the nation’s war on obesity has been top of mind and sugars are fingered as one of the main culprits. Diets loaded with lots of sugar are being blamed for the overweight and obesity epidemic. The types of sugars villainized for much of the the overweight and obesity epidemic are primarily added sugars. These sugars are called “empty calories” because they provide mostly calories, very few nutrients and are so easy to over consume. There is no question that our desire for sweet food and drinks adds a lot of extra calories. But sugar alone or how it is processed in the body is not necessarily responsible for weight gain. Eating more calories than you need, regardless of the source, coupled with sedentary lifestyles is the real problem. Natural vs. Added Sugars Much of the concern over sugars is due to the confusing terminology. All sugars are a type of carbohydrate, have four calories per gram but they are not all equal. The majority of sugars we eat are added sugars that have been added during processing, preparation or at the table to sweeten and improve taste. Naturally occurring sugars from fruits, vegetables and dairy are not the sugars of concern. Foods and beverages containing natural sugars (fructose and lactose) are vehicle foods because they deliver healthy nutrients to the diet in addition to the natural sugars. Added sugars come in all different forms from table sugar, honey, agava, maple syrup to high fructose corn syrup. While there are small differences between these sugars, basically they offer little more to the diet than extra calories and sweetness. A recent review of the scientific literature suggests it is most likely a problem of overconsumption of calories, not high fructose corn syrup or any other added sugar. How Much Sugar? Americans eat plenty of sugar. The average intake of added sugars is 22 teaspoons per day (355 calories), an increase of 19 percent compared to previous intake data, according to the Harvard School of Public Health. The 2010 Dietary Guidelines for Americans estimates added sugars contribute about 16 percent of our total calories. They recommend limiting total intake of discretionary calories, which includes added sugars, to 5–15 percent of daily caloric intake. Fruit Juice Dilemma One of the concerns about the natural sugars in juice is that with little fiber, they are quickly absorbed and easy to over consume. However, some studies suggest that drinking 100% fruit juice is associated with a more nutritious diet overall, including reduced intake of dietary fat, saturated fat and added sugars. Drinking your fruits and veggies is a convenient way to add powerful plant-based nutrients to your diet. One-hundred-percent fruit juice is a nutritious and can be a beneficial part of a healthy diet and may be consumed in the place of whole fruits as recommended by the U.S. Department of Agriculture’s (USDA’s) 2010 Dietary Guidelines for Americans. A one-half-cup serving (4 ounces) of 100% fruit juice provides the equivalent of one-half-cup of fruit to help meet USDA’s daily serving recommendation. Experts suggest limiting 100% fruit juice to 1-2 servings per day. The American Academy of Pediatrics suggests limiting 100% fruit juice to 4-6 ounces for children 6 and younger and 8-12 ounces for children 7-18 years. Impact of Sugar on Health Over the years, excess sugar intake has been associated with several chronic diseases including diabetes, cardiovascular disease, obesity, dental caries and hyperactivity in children. Although evidence is limited, a high intake of added sugars may be associated with an overall greater calorie intake, higher body weights and lower intakes of important nutrients. In addition, eating a sugar laden diet may displace healthier, more nutrient rich foods. Individuals who consume excess calories in the form of sugar also tend to fall short of meeting nutritional needs. Reducing added sugars, the solution most experts are encouraging, may lower calorie intake of the diet without compromising nutrient adequacy. In 2009 the American Heart Association recommended limiting added sugar because of health risks. Recommended limits are based on age, sex and calorie levels. It is prudent to limit sugar to no more than 100 calories per day for women and 150 calories per day for men. Understanding Sugar on Food Labels It is hard to distinguish natural from added sugars on packages. All sugars are lumped together on the nutrition facts panel. It is anticipated that added and natural sugars will be listed separately in the next version of the nutrition facts panel. The only way to determine the type of sugars is to check the ingredient list for added sugars. Natural sugars like fructose and lactose will not be listed on the ingredient list because they are naturally occurring in the product and not a source of added sugars. Ingredients are listed by weight from the greatest to the least so any sugars listed in the first few ingredients are in greater quantity. Putting Sugar in Perspective Good nutrition goes beyond calories and sugar. What really matters is the total diet and lifestyle. There is nothing wrong with added sugar in the diet as long as it is limited and does not squeeze out more nutritious foods. It is important to distinguish that beverages and foods made with whole fruits, vegetables and 100% fruit juice contain naturally occurring sugars along with a wealth of good-for-you nutrients. Diets rich in fruits and vegetables contain an abundance of essential vitamins, minerals, antioxidants and fiber, and may provide defense against chronic diseases such as obesity, diabetes, certain cancers and more. There may be too much sugar in American diets but it is not coming from fruits and vegetables but rather from foods and beverages sweetened with added sugars. The information provided in this article is for general informational purposes only and not intended to be nor should be construed as medical advice. You should consult your own doctor to determine what may be right for you. Insurance coverage provided by or through UnitedHealthcare Insurance Company or its affiliates. Administrative services provided by United HealthCare Services, Inc. or their affiliates. M52311-B 8/14 © 2014 United HealthCare Services, Inc.